A new study has shown that replacing the saline in IV bags with “balanced crystalloids” solutions which are closer to human blood could be used to save lives. Two connected studies, one on adults who were not critically ill, and another carried out on patients in an intensive care unit, found that patients who were given balanced crystalloids were less likely to suffer from kidney problems during the study.
The ICU patients on these fluids also had lower death rates. The authors of the study believe that switching patients to different fluids could result in saving thousands of lives every year. During the studies, researchers looked at the data of nearly 16,000 patients. Of those given saline solution, 15.4% developed serious kidney problems and 11.1% died within the first month. Of those given balanced crystalloids the figures were 14.3% and 10.3% retrospectively.
Study author Dr. Todd W. Rice, director of the medical intensive care unit at Vanderbilt University Medical Center and an associate professor of medicine in its Division of Allergy, Pulmonary, and Critical Care Medicine commented that “Saline has been used in practice for over a century. We actually heard from a number of people that there couldn’t have been much difference between these two (intravenous fluids), because we would have already known it if there was.”
He added that changing the fluids that are given to critically ill patients could make a substantial difference when you take into account the population size. He added: “We’ve tried to do a lot of history-looking to figure out why saline became the default. It’s not entirely clear.” Rice, along with the other researchers who were involved in the study noted that neither type of fluid costs more than the other, and both are widely available.
The fluids given in IV bags should mirror the salt concentration in human blood. As saline contains a large amount of sodium chloride, it’s no surprise that it can affect kidney function and lead to some metabolic issues in patients. Dr. David Hager, associate director of the medical ICU at the Johns Hopkins Hospital, who was not involved in either study said: “This study makes me think again about what choice of fluids I’ll use now.”